2024 Referral List
Do I need referrals with my plan?
- PPO plan members: No referrals needed.
- HMO plan members in Florida, Illinois, or Texas: You'll need referrals for certain specialists — check the lists below to see which ones.
- HMO plan members in all other states: No referrals needed.
If your plan requires referrals and you have an Advocate Physician Partners (APP) primary care provider, APP will manage your referrals.
HMO plans in Florida, Illinois, or Texas
You need a referral for:
A
Allergist (Immunologist)
C
Cardiac electrophysiologist
Cardiologist
Cardiovascular surgeon
Colon and rectal surgeon
D
Dermatologist (Florida members: only for visit 6 and beyond)
E
Endocrinologist (not required for C-SNP plans in Texas)
ENT (Ear, nose, and throat specialist)
G
Gastroenterologist
General surgeon
Genetic counselor
Gynecologic oncologist
H
Hand surgeon
Hematologist
Hepatologist
Hospice and palliative medicine specialist
I
Infectious disease specialist
Interventional cardiologist
M
Medical geneticist
N
Nephrologist (not required for C-SNP plans in Texas)
Neurological surgeon
Neurologist
O
Oncologist
Oral surgeon (Maxillofacial surgeon)
Orthopedic surgeon
Otolaryngologist (Ear, nose, and throat specialist)
P
Pain management specialist
Physiatrist
Plastic surgeon
Pulmonologist
R
Radiation oncologist
Reproductive endocrinologist
Rheumatologist
S
Sleep disorders specialist
Spinal cord injury specialist
Sports medicine specialist
Surgeon
T
Thoracic surgeon
U
Urologist
V
Vascular surgeon
You don't need a referral for:
A
Acupuncturist
Addiction psychiatrist
Anesthesiologist
Audiologist
C
Certified diabetes educator (CDE)
Certified nurse-midwife
Certified nursing assistant (CNA)
Certified professional midwife
Certified registered nurse anesthetist (CRNA)
Chiropractor
Critical care medicine specialist
D
Dentist
Dialysis
E
Emergency medicine specialist
F
Family medicine physician
Forensic pathologist
G
General practitioner
Geriatric medicine specialist
Gynecologist
H
Hospitalist
I
Internist
L
Licensed mental health counselor
Licensed nurse (LPN or LVN)
N
Nurse practitioner (NP)
O
Obstetrician
Occupational medicine specialist
Occupational therapist
Ophthalmologist
Optician
Optometrist
P
Pathologist
Perinatologist
Pharmacist
Physical therapist
Physician assistant (PA)
Podiatrist
Psychiatric nurse
Psychiatrist
Psychologist
R
Radiologic technologist
Radiologist
Recreational therapist
Registered dietitian (RD)
Registered nurse (RN)
Respiratory therapist (RT)
S
Social worker
Speech therapist